C HAPTER 12: W ORKFORCE E NGAGEMENT
T HROUGH C OLLECTIVE A CTION AND
G OVERNANCE
Yoder-Wise: Leading and Managing in Nursing, 8th Edition
MULTIPLE CHOICE
1. Collective action is effective in:
a. ensuring that needs of nurses are placed ahead of other disciplines.
b. defining nursing as a profession.
c. advising patients of the needs of nurses.
d. amplifying the influence of individuals.
ANS: D
Individuals may have limited influence in achieving various purposes
such as advancement of qualit y care or of the profession, whereas
collective action helps to define and sustain individuals in achieving
the desired purposes.
TOP: AONE competency: Business Skills
2. Nurses on the dial ysis unit notice that changes in labeling of fluids have
meant several alarming near miss in terms of wrong administration of
fluids. They take this concern to the unit manager. As an advocate of
, nurse autonom y, the most appropriate response in this situation would be
to:
a. ensure that the nurses are aware of the reasons for the change and
how the decision was made about the new labels.
b. discuss concerns about the labels and develop potential solutions
that take into account changes that can be made at the local level
and those that need system intervention.
c. suggest that the staff wait until they have become more familiar
with the labels before taking further action.
d. tell the staff that you will notify the pharmacy about these concerns
and leave it up to the pharmacy to decide what should be done.
ANS: B
Participation in decision making regarding one‘s practice is an
appropriate expectation for professional nurses, provides for greater
autonom y and author it y over practice decisions, contributes to
supporting the professional nurse, and is a major component of job
satisfaction. Autonomy is encouraged through supportive management
and through unit -level support of changes without the need for
complex, multil evel approval of changes that can be made locall y.
TOP: AONE competency: Leadership
3. Martin, the unit manager, receives complaints from community agencies
that patients who have been discharged from his unit seem to lack
understanding about their disorder and immediate strategies for managing
elements of their care. Martin checks the patient teaching sheets and notes
that the sheets are initialed by staff. He calls the agencies and indicates
that teaching has been done. Martin ’s follow-up to complaints fro m the
communit y is:
, a. appropriate and indicates that he has assumed accountabilit y for the
actions of his staff.
b. indicative that he does not clearl y understand the concept of
accountabilit y.
c. indicative of strong support for his staff and their autonom y.
d. important in clarifying the difference between his accountabilit y
and that of the communit y in patient care.
ANS: B
Accountabilit y refers to the achievement of desired outcomes. If
communit y agencies are noticing that limited or no change in patient
behavior has occurred despite teaching on the unit, then the staff has
not achieved accountabilit y, and he is not holding his unit responsible
for the outcomes. Martin is also demonstrating lack of accountabilit y.
TOP: AONE competency: Professionalism
4. Sarah determines, in partnership with her patient, that current medications
are not enabling her patient, a married account executive with
fibrom yalgia, to continue with her employment and famil y
responsibilities. After searching for additional information on
fibrom yalgia, Sarah finds nonpharmacologic interventions that are
supported through credible evidence. Sarah suggests that the patient, her
physician, and she meet to discuss the medications and possible options
and a plan of care for the patient ’s discharge. This action exemplifies
which of the four historical concepts?
a. Authorit y
b. Responsibilit y
c. Communication of conflict
d. Autonom y
T HROUGH C OLLECTIVE A CTION AND
G OVERNANCE
Yoder-Wise: Leading and Managing in Nursing, 8th Edition
MULTIPLE CHOICE
1. Collective action is effective in:
a. ensuring that needs of nurses are placed ahead of other disciplines.
b. defining nursing as a profession.
c. advising patients of the needs of nurses.
d. amplifying the influence of individuals.
ANS: D
Individuals may have limited influence in achieving various purposes
such as advancement of qualit y care or of the profession, whereas
collective action helps to define and sustain individuals in achieving
the desired purposes.
TOP: AONE competency: Business Skills
2. Nurses on the dial ysis unit notice that changes in labeling of fluids have
meant several alarming near miss in terms of wrong administration of
fluids. They take this concern to the unit manager. As an advocate of
, nurse autonom y, the most appropriate response in this situation would be
to:
a. ensure that the nurses are aware of the reasons for the change and
how the decision was made about the new labels.
b. discuss concerns about the labels and develop potential solutions
that take into account changes that can be made at the local level
and those that need system intervention.
c. suggest that the staff wait until they have become more familiar
with the labels before taking further action.
d. tell the staff that you will notify the pharmacy about these concerns
and leave it up to the pharmacy to decide what should be done.
ANS: B
Participation in decision making regarding one‘s practice is an
appropriate expectation for professional nurses, provides for greater
autonom y and author it y over practice decisions, contributes to
supporting the professional nurse, and is a major component of job
satisfaction. Autonomy is encouraged through supportive management
and through unit -level support of changes without the need for
complex, multil evel approval of changes that can be made locall y.
TOP: AONE competency: Leadership
3. Martin, the unit manager, receives complaints from community agencies
that patients who have been discharged from his unit seem to lack
understanding about their disorder and immediate strategies for managing
elements of their care. Martin checks the patient teaching sheets and notes
that the sheets are initialed by staff. He calls the agencies and indicates
that teaching has been done. Martin ’s follow-up to complaints fro m the
communit y is:
, a. appropriate and indicates that he has assumed accountabilit y for the
actions of his staff.
b. indicative that he does not clearl y understand the concept of
accountabilit y.
c. indicative of strong support for his staff and their autonom y.
d. important in clarifying the difference between his accountabilit y
and that of the communit y in patient care.
ANS: B
Accountabilit y refers to the achievement of desired outcomes. If
communit y agencies are noticing that limited or no change in patient
behavior has occurred despite teaching on the unit, then the staff has
not achieved accountabilit y, and he is not holding his unit responsible
for the outcomes. Martin is also demonstrating lack of accountabilit y.
TOP: AONE competency: Professionalism
4. Sarah determines, in partnership with her patient, that current medications
are not enabling her patient, a married account executive with
fibrom yalgia, to continue with her employment and famil y
responsibilities. After searching for additional information on
fibrom yalgia, Sarah finds nonpharmacologic interventions that are
supported through credible evidence. Sarah suggests that the patient, her
physician, and she meet to discuss the medications and possible options
and a plan of care for the patient ’s discharge. This action exemplifies
which of the four historical concepts?
a. Authorit y
b. Responsibilit y
c. Communication of conflict
d. Autonom y
